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Gastroenteritis Flashcards

1
Q

campylobacter

incubation period and symptoms?

A

incubation period is around 3-10 days

causes inflammation of the colon and rectum - occasionally invading its way into the blood stream

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2
Q

source of campylobacter?

A

undercooked poultry, infected water and unpasteurised milk

person to person outbreaks are uncommon and a mass outbreak is due to a large group being subject to the same conditions

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3
Q

management of Campylobacter?

A

usually self limiting but give erythromycin or ciprofloxacin for 5 days if systemic symptoms develop

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4
Q

incubation period of salmonella enertica?

A

12-48 hours

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5
Q

pathophysiology of salmonella enertica?

A

inflammation of ileum and colon - bacteria then multiply in the gut and cause mucosal damage - decreasing fluid absorption and increasing fluid release
can also find its way into the blood stream rarely

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6
Q

symptoms of salmonella enertica?

A

abdominal pain, diarrhoea (sometimes bloody), vomiting

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7
Q

source of salmonella enertica?

A

undercooked poultry

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8
Q

management of salmonella enertica?

A

is usually self limiting but give ciprofloxacin if systemic symptoms start

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9
Q

incubation period of shigella spp.?

A

1-9 days

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10
Q

pathophysiology of shigella spp.?

A

invades into he mucosa of the small intestine causing inflammation but doesn’t go any further - so will never be seen in blood cultures

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11
Q

symptoms of shigella spp?

A

abdominal pain, diarrhoea (sometimes bloody and contain pus)

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12
Q

source of shigella?

A

human infection only - person to person contact

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13
Q

management of shigella spp.?

A

usually self limiting - other forms of shigella that are picked up abroad may be more severe and may need treatment with ciprofloxacin

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14
Q

E coli 0157 pathophysiology?

A

this strain of E coli produces a toxin that damages red blood cells and the kidney, causing haemolytic-uraemic syndrome - therefore increasing blood urea, red cell haemolysis and low levels of platelets within the blood

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15
Q

what is the toxin called in E coli and what is its mode of action?

A

verotoxin binds to the receptors found in renal cells, RBC and others - the toxin inhibits protein synthesis and cause cell death

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16
Q

source of E coli 0157?

A

carried as part of normal gut flora in cattle, but becomes contaminated when outside during slaughter - so caused by burgers/mince rather than steak

can also be caused by visits to farms and private untreated water sources which have been infected

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17
Q

management of E coli?

A

symptomatic and supportive treatment only - antibiotics should not be used as they can increase the levels of toxins within the blood - the bloods of a patient with E coli must be checked 1 week after to look for signs of HUS

18
Q

incubation period for typhoid?

A

14-21 days - the infection are febrile to begin with and they circulate within the bloodstream - causing headaches, flu like symptoms and then diarrhoea 3 weeks later

19
Q

symptoms of typhoid?

A

fever, rash on abdomen (rose spots) and diarrhoea

20
Q

source of typhoid?

A

human infection only - spread form person to person from drinking contaminated water, and poor sanitation

21
Q

management of typhoid?

A

antibiotics are required - resistance to ciprofolxacin is high in developing countries - azithromycin is often used

22
Q

cholera incubation period?

A

1-9 days

23
Q

pathophysiology of cholera?

A

organism produces a exotoxin that causes active outpouring of fluid cells from the small intestine - resulting in severe extremely watery diarrhoea (rice water stools) - causing rapid dehydration

24
Q

source of cholera?

A

person to person spread from contaminated water/poor sanitation

25
Q

management of cholera?

A

fluid and electrolyte replacement - antibiotics are not indicated

26
Q

pathophysiology of C. Difficle?

A

The pathogenic c. difficle (anaerobic gram positive spore forming bacillus) dominate the flora when the normal flora of the gut has been disrupted due to antibiotics taken to cure a previous infection

27
Q

what are the host risks for c difficle?

A 
age greater than 65
immunosuppressed 
PPI drugs 
Hospitalisation/long term care 
previous C. Diff infection
28
Q

prevention of C diff?

A

prompt isolation and treatment of infected individuals

controll antibiotic usage - control the 4 C’s

  • clarthromycin
  • co-amoxiclav
  • ciprofloxaccin
  • clindamycin
29
Q

what GI infections are associated with ingestion of preformed toxins?

A
  • staph aureus
  • clostridium perfringens
  • bacillus cereus
30
Q

example of staph aureus infection?

A

baker touches cream to put on a cake, bacteria multiply in the cream producing a enterotoxin which is ingested by the customer

the toxin is absorbed quickly - acting directly on the vagus nerve - vomiting commences within 1-2 hours

31
Q

example of clostridium perfringens infection?

A

(large gram positive anaerobic bacilli)

spores of of the bacteria survive cooking, then for vegetations which produce enterotoxins

heavily associated with reheated gravy

32
Q

example of a bacillus cereus infection?

A

(large gram positive aerobic bacilli)

similar to clostridium perfringens infection in that the bacterial spore survive cooking, form vegetations then release enterotoxins

heavily associated with inadequately reheated rice

33
Q

examples of short incubation times?

A

staph aureus and bacillus cereus

34
Q

examples of medium incubation times?

A

salmonella and clostridium perfringens

  • the medium incubation time suggest invasion of a toxin within the gut
35
Q

examples of long incubation times?

A

campylobacter/Ecoli 0157

suggest invasions of toxin within the gut and they are often associated with bloody diarrhoea

36
Q

examples of parasites that cause GI infections?

A
  • cryptosporidium
  • giardia lamblia
  • enetrobius vermicularis
37
Q

characteristics of and giadia lamblia cryptosporidium?

A

‘protozal’ – single organism infection

infection occurs when cysts are ingested and hatch into trophozoites that invade cells within the small intestine

38
Q

source and symptoms symptoms of cryptosporidium?

A

domestic animals (calves) person to person spread as well as contaminated water and swimming pools

diarrhoea that is particularly severe in patients suffering from HIV

39
Q

source, symptoms and treatment of giardia lamblia?

A

person to person spread - associated with contaminated water supplies

diarrhoea, malabsorption syndrome, anorexia, abdominal pain, flatulence

oral metronidazole

40
Q

characteristics of a enterbius vermicularia “threadworm” infection?

A

tiny white worms that look like small pieces of thread when passed in stools – seen in school children and will often infect several members of the family

41
Q

pathophysiology if enetrbius vermicularia?

A

eggs are ingested, hatch in the intestine and live in the caecum and colon, females then come out to lay eggs in the perianal area at night, child scratches bottom and then puts fingers in mouth

symptoms – perianal itch, worms seen in stool

42
Q

source and management of “threadworm” infection?

A

human to human contact only - poor hygiene

oral mebendazole - often has to be used to treat the whole family

GI (5 decks)

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